Rotational stability and patient satisfaction after implantation of a new toric IOL

Rotational stability and capsular bag performance of a hydrophobic acrylic open-loop single-piece intraocular lens

PURPOSE

To evaluate the rotational stability and capsular bag performance of a blue light-absorbing hydrophobic acrylic open-loop single-piece intraocular lens (IOL) with a blast-finished anchor wing haptic design during the first 6 postoperative months.

METHODS

In this prospective clinical study, patients with age-related cataract and potential postoperative corrected distance visual acuity (CDVA) of 0.2 logMAR or better were included. The patients received a non-toric hydrophobic acrylic single-piece IOL with an axis mark (YST0.00; Nidek Co. Ltd, Japan). Surgeries were video-taped. Retroillumination images were acquired 1 h, 1 week and 6 months postoperatively. Rotational stability was assessed by precise image overlay. At 6 months, Purkinje meter measurements were performed to evaluate tilt and decentration.

RESULTS

In total, 100 eyes of 77 patients were included in the analysis. Mean absolute rotation was 2.1 ± 1.7° (median 1.7, range: 0-7.9) at 6 months (1 h - 6 months postoperatively). IOL rotation was ≤3° and ≤6° in 74 (74%) and 98 (98%) eyes, respectively. Mean absolute IOL rotation from the end of surgery to 6 months was 2.5 ± 2.2° (median 2.3, range: 0-15.6; n = 78). Mean tilt (pupillary axis) and decentration were 4.1 ± 1.9° (median 4.0, range: 0.5-8.2) and 0.35 ± 0.17 mm (median 0.32, range: 0.06-0.91) respectively (n = 84). Postoperatively, 98 (98%) eyes achieved a CDVA of 0.2 logMAR or better, 95 (95%) of ≤0.1 and 81 (81%) of ≤0.0.

CONCLUSIONS

This hydrophobic acrylic single-piece IOL showed an excellent rotational stability and capsular bag position with low tilt and decentration values.

Patient-reported outcomes of multifocal and accommodating intraocular lenses: analysis of 117 patients 2-10 years after surgery

Purpose

The purpose of this study was to determine the satisfaction levels of patients at least 2 years after cataract surgery implantation with bilateral accommodating or bilateral multifocal intraocular lenses (IOLs) and to determine the relative rate of spectacle independence and adverse symptoms in that same time frame.

Design

Patient questionnaire administered in a single-center private practice at least 2 years after cataract surgery with presbyopia-correcting IOL implantation.

Methods

Patients who had undergone uncomplicated cataract surgery with an accommodating or multifocal IOL implant were eligible for inclusion. Patients with visually significant non-IOL-related postoperative morbidity were excluded. Patients with astigmatism or residual refractive error were not excluded. The main outcome measure was patient satisfaction at least 2 years after IOL implantation.

Results

Sixty-eight patients who received accommodating lenses and 49 patients who received multifocal lenses completed the questionnaire. The mean age of all patients was 75.7 years at the time of survey; the mean number of years since cataract surgery was 5.4 years. Overall, there were no significant differences between the two groups or within each group between the different lenses used. About 90% of patients in each group were “very satisfied” or “somewhat satisfied” with their vision at least 2 years after the initial surgery. Conversely, only one in eleven patients found his vision to be worse than expected.

Conclusions

The majority of patients who received either accommodating or multifocal IOLs remain satisfied with their lens of choice more than 5 years after the original surgery. Glare and halos remain more noticeable in patients who received multifocal lenses.

True rotational stability of a single-piece hydrophobic intraocular lens

BACKGROUND

To evaluate rotation and its influencing factors of an aspheric one-piece hydrophobic acrylic intraocular lens (IOL) Vivinex XY1 during 6 months after operation.

METHODS

In this institutional trial, 122 eyes of 66 patients were implanted with a non-toric aspheric IOL Vivinex XY1 (Hoya Corporation, Tokyo, Japan). IOL alignment was assessed at the end of surgery, 1 hour, 1 week, 1 month and 6 months after implantation. Confounding factors such as axial length, presence of anterior fibrosis and randomised implantation in four different intended axes (0°, 45°, 90°, 135°) were evaluated. Decentration and tilt were measured using a Purkinje metre.

RESULTS

Assessment of rotational stability was possible for 103 of 122 implanted IOLs 6 months after eye surgery. The median absolute rotation was 1.1° (range: 0°-5°). Rotation was significantly increased within the first hour after operation compared with later time-points (p<0.001). No correlation was found with axial length and rotation (Spearman's r=0.048, p=0.63). No significant difference was observed regarding different implantation axes (p=0.75). Rotation was not influenced by the presence of anterior fibrosis (p=0.98).

CONCLUSION

Assessing the true IOL position at the end of surgery is crucial for the evaluation of rotational stability of IOLs. No IOL rotation exceeding 5° could be detected 6 months after surgery.

Long-term rotational stability and visual outcomes of a single-piece hydrophilic acrylic toric IOL: a 1.5-year follow-up

AIM

To evaluate the rotational stability and visual outcomes of a single-piece hydrophilic acrylic toric intraocular lenses (IOL) over a 1.5-year follow-up period. Data from the 6-month follow-up study have been previously reported.

METHODS

Forty eyes of 26 cataract patients (mean age: 72.8±7.9y) with pre-existing corneal astigmatism of 1.0 to 2.6 D were enrolled in the study. Mean axial length was 23.17±0.88 mm. Main outcome measures after implantation of the Torica-aA IOL (HumanOptics) were IOL rotational stability, subjective refraction, astigmatism correction, uncorrected and corrected distance visual acuity (UDVA, CDVA).

RESULTS

There was no significant change in the parameters evaluated between the 6-month and 1.5-year follow-ups. At last visit, mean absolute IOL rotation (objective method) was 1.81°±1.87° (range 0.00° to 7.20°) with 78.6% of eyes having IOL rotation <3°, 92.9% of eyes <5° and 100% of eyes <8°. No patient required secondary IOL repositioning during the course of the study. Mean residual refractive cylinder was -0.60±0.40 D. There was a significant reduction in the magnitude of the J₀ vector postoperatively (P<0.0001) with a mean absolute change of 0.76±0.40 D. The mean J₄₅ vector was close to zero preoperatively and postoperatively and didn't change significantly (P=0.28). Mean monocular UDVA and CDVA was 0.09±0.12 logMAR and -0.01±0.12 logMAR, respectively. No treatment with Nd:YAG laser was required.

CONCLUSION

The Torica-aA IOL shows good and stable visual performance and rotational stability over a 1.5-year follow-up period.